Rush Limbaugh, Victim, Perp or none of the above? (Part 2)
He reported that overseas pharmacies inform American buyers that U.S. Customs will not seize shipments of drugs because a "personal use" policy allows customers to import a limited supply of drugs. As a result, Law enforcement agencies that try to manage online pharmacy abuse are finding it a challenge to do so. (This is true. Read the FDA Regulations and their contrary policy at http://rxasia.com/import.html ) If the package doesn't contain narcotics or controlled substances, they normally reseal the package and release it for delivery by mail. In the very unlikely event that a package is detained, US Customs normally sends a letter informing the recipient that they need to mail a copy of a doctor's prescription or else the package will be returned to sender or destroyed. To repeat, it is not illegal to order legitimate medications from abroad for personal use. Let the buyer beware concerning controlled drugs or narcotics.) He talked about one instance in Arizona where authorities found an online pharmacy with an Arizona mailing address that was being hosted in another state. The resident physician signing off on prescriptions was discovered to be a retired veterinarian living in Mexico. The Arizona State Attorney General had tried to stop out-of-state and overseas Internet doctors from doing business with state residents, but lacked the power and enforcement muscle to stop them. In spring the National Association of Boards of Pharmacy developed the Verified Internet Pharmacy Practice Sites (VIPPS) program. Boards from fifty states, the District of Columbia, three U.S. territories, nine Canadian provinces, and four Australian states make up the association membership. Although nine of Canada's provinces fall under the Verified Internet Pharmacy Practice Sites program, a search didn't turn up any online Canadian drugstores. (Three cheers for the Canadians for not capitulating to another self-appointed regulatory agency.) (I would think that this Verified Internet Pharmacy Practice Sites (VIPPS) program is a self-serving organization, allowing only USA certain, Canadian and Australian chain pharmacies to join. The Good Old Boys Club all over again to stifle competition. And who needs another regulatory agency to complicate life. There is enough regulation already in place to address any real, perceived or imaginary problem). According to Dr. Paul Raymond of Online Pills, Canadians are able to buy prescription drugs from his company in Atlanta, Georgia. They are currently shipping several orders a day to Canada. Pill Box's president William A. Stallknecht, R.Ph., said that Canadians can legally purchase drugs online and can also get diagnosed online as well at medicalcenter.net. In most cases patients need to physically see a physician but in some instances diagnosis is made online. In his article, Spring quoted Stallknecht, as saying that, "These prescriptions are not illegal. They're bona fide prescriptions with bona fide doctor-patient relationships." Stallknecht said that," one out of three prescriptions written are prescribed by doctors who've never seen their patients." Spring reported him as saying that the pharmaceutical drugs he sells online primarily Viagra, Propecia, Claritin, and Xenical are safe. These drugs only require a prescription because manufacturers are "milking their patents" before they expire and the drugs become available over the counter. (I don't think our pharmaceutical industry would do that! Do you? Profit before compassion? Nah!) Having stated all the legal ramifications of on-line drug stores, the fact still remains that consumers love them. One of the main reasons is that it provides consumers with considerable privacy. In an article in August, Troy Wolverton on CNET News.com reported that on its first day of trading, Drugstore.com closed at 50.25, giving the company a market valuation of some $2.13 billion. Soma.com sold itself to CVS for $30 million in stock in May. Financial analyst Chris Vroom of Thomas Weisel Partners was reported as saying that the potential size of the pharmacy market and the sense that the Web is a natural place to sell drugs makes online companies attractive to investors. (Could all this commotion and Public Relations be because the large chains were late getting on board?) The Globe and Mail reported in March that Michael Tchong, editor of Iconoclast, estimated that 76 million baby boomers are all going to be over 40 by the year 2004 and health will start to play a more important role. Studies indicate that the baby boomers are already driving the online drug store industry. John Barry wrote in part on June 15, 2000 at http://speakout.com/ "Online pharmacies allow patients to purchase medicine without having to go to the drug store. These sites give them direct access to information about the drugs and direct contact with the pharmaceutical companies that which they didn't have before. The new technology, however, has a major drawback: it makes it a lot easier to buy prescription drugs without the advice or supervision of a doctor. Is it time for the federal government to move in and stop these abuses? (Big Brother redux! If I sound cynical, it's because I Am. I resent big government activist hacks dictating and regulating every part of our lives. ) According to the 1938 Food, Drug, and Cosmetic Act, prescription drugs cannot be sold without direct involvement of a physician. But with the Internet, this "intervention" becomes a lot less direct. While many on-line pharmacies require that their customers supply either a hand-written or faxed prescription from a doctor, others have begun to introduce "virtual" physicians into the process. These online pharmacies only ask the patient to send a completed form over the Internet. Then, for an additional fee, a licensed physician determines the dosage and the type of medicine for the patient based on the information he or she has been given. (This is a good thing.) Two problems immediately arise. First, the patient may not be supplying the right information. (God knows we wouldn't lie to our personal physician, would we?) Second, the doctor may not exist. In a country that which has the strictest drug regulations in the world (much of which are not needed or redundant with other regulations. I guess this is the seat belt and motorcycle helmet mentality.) This radically short-circuits the traditional doctor-patient relationship. What happens when the patient decides on his own that more is merrier? In Illinois, a 52-year-old man with a heart condition who was taking the impotence drug Viagra suffered a heart attack and died after buying the drugs from an on-line pharmacy. (There are also reports of physician prescribed Viagra causing the same heart attacks, so this is just another scare tactic.) Another online company, meanwhile, was sued recently for selling Viagra to a 16- year-old. I didn't know there was an age limit for Viagra. There has to be a case where a regular doctor prescribed Viagra for a 16 year old as well.) In a U.S. News survey, several companies selling Viagra and Propecia (for hair loss) were dispensing the medication without a physician; the only qualified doctor on the company's payroll was out-of-state. (The drug Propecia also has been associated in the mass media in recent months with allegedly greater-than-average health risks), as is the drug Xenical (weight reduction).) (I guess then that U.S. News thinks all the "legal" scripts by qualified personal physicians were OK health risks.) All of these drugs are widely purchased over the Internet, sometimes creating a complex network where the patient, the consulting physician, and the pharmacy are all in different states. Other "cure all" drugs are sold over the Internet, including beef tallow (for cancer), a Peruvian plant derivative (for AIDS), and magnetic devices (for high blood pressure). With over 400 pharmacy sites already on the web (2000 figure - I would venture a estimate of 1000 ' 2000+ as of October 2003 if you take into consideration affiliates) - up from a few dozen five years ago - it's becoming increasingly difficult to enforce laws which prevent selling prescription drugs without a bona fide prescription from a licensed physician. The relationship between online pharmacies and physicians in these cases can be tenuous or impossible to verify, since many on-line pharmacies don't provide addresses or phone numbers of consulting physicians. When violations are traced, the penalties are usually minimal. '''" So what to do? I have established several guidelines for myself based on my experience, which I believe is relatively unbiased. Most drugs requiring a prescription in the USA & Canada & UK & Australia DO NOT require a prescription in the rest of the world. Never order an online drug that a physician has not initially prescribed for you. It is dangerous to your life, health and well-being. You should have a prescription, although this is usually unnecessary with offshore pharmacies. (Caveat Emptor ' Let the buyer beware!) There are unsubstantiated reports of expired and bad medication coming from Mexico. But you might find a good one. Personally, I would pass up an Online Mexican pharmacy, unless you travel to the border towns personally and know them to be reputable. Never deal with an online pharmacy that sells controlled or narcotic prescriptions as it is a sure bet their shipments are more scrutinized by US & Canadian customs, and you run a higher risk of seizure of your order. These sites also stand a greater risk of shutting down because of US Government intervention, pressure and prosecution. If you are seeking controlled or narcotic prescriptions, be prepared for scrutiny, seizure or worse from the FDA, DEA, Customs and other agencies. RxAsia does not sell controlled or narcotic prescriptions by any means. I advise against this vehemently. If you are addicted, please seek help. If it is still your intention to order these substances for your condition, use caution and order from several different sources for your own safety. Be prepared to have some shipments seized. Pick an online pharmacy that offers a wide variety of prescription medication, not just the most profitable and popular. They are more apt to be legitimate pharmacies, and not pill mills. Does the Online Pharmacy take the time and effort to give you information on your drug? Is it easy to navigate? Are the prices attractive to you? If you answered "YES" to all three, you found your online pharmacy. It's a fact that offshore drug prices are usually cheaper outside the USA and Canada by 30% to 80%. Even offshore prices vary, based on the country and supply availability. Find an offshore pharmacy you feel comfortable with and order an initial small order before placing a more substantial order. Check the expiration dates to make sure you are not getting an expired medication. I know for a fact RxAsia and others maintain a minimal stock and constantly re-order medicine so that expiration is not a problem just like the large pharmacy chains in the US & Canada. Order two weeks or more ahead of the time you will need the medication. It is not uncommon for customs to be backed up, especially during holidays. If you are ordering medications you will be taking for the rest of your life, follow your doctor's orders for periodic checkups and testing. If you feel ill, for whatever reason, take all your medications with you and seek competent medical help. Do not deal with companies in Africa and Eastern Europe.
About the author: Bill Kammarada started in the computer industry as an analyst in 1961. He is a Computer Consultant and Webmaster for www.RxAsia.com Following the loosening of FDA rules on Orphan Drugs and other drugs not supplied in the USA, he studied the subject extensively. He was asked to leave Hofstra University (NY) for not taking them seriously and went to Pace University (NY) where he majored in sarcasm and non-matriculation. You can reach Bill at firstname.lastname@example.org.